Click here to download

"Le infermiere sanno quello che i medici vogliono": il lavoro di congiunzione nei TDEs
Author/s: Enrico Maria Piras, Alberto Zanutto 
Year:  2014 Issue: Language: Italian 
Pages:  21 Pg. 29-49 FullText PDF:  98 KB
DOI:  10.3280/SO2014-001002
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 

The relationship between work processes and technological innovations is a recurring theme of all the disciplines interested in organizational analysis. The majority of the studies focus on the introduction on new technologies to evaluate the effects of work organization while less common are the analysis of long term effects and of the stratification of technical artefacts that, over time, lead to the creation of Technologically Dense Environments. This work addresses these issues through an empirical analysis of "junction work", the array of apparently marginal activities performed by human actors to allow information systems to be aligned. The interest in junction work stems from its being considered a undesired by-product of innovation. Junction work takes the form of copying hand notes, transcribing data from one system to another (digital or paper-based), data inputting and so on. We present the case of information management in an oncological department ten years after the deployment of an electronic medical record and is based on qualitative interviews and participant observation aimed at discovering the origin of junction work, its analysis and the changes in the professional profile of the people that perform it. Results show that innovation process, guided by medical doctors, is intertwined with a delegation to nurses of a growing role as information managers. The overall outcome is the transformation of the ward into a technologically dense environments in the nurses experience, required to perform a constant junction work to ensure the information flow within the department and with the rest of the other facilities. Results therefore confirm how the cumulative effects of technological stratification have a different impact on organizational actors. Despite being represented as transient and accidental, junction work appears a constitutive element of technologically dense environments and it can therefore be considered as a useful unit of analysis to study them.
Keywords: Technologically dense environments, junction work, nursing, information systems.

  1. Alby, F., Zucchermaglio, C. (2005), Gruppi e tecnologie al lavoro, Bari, Laterza. Bowker, G.C. (1994), Science on the Run: Information Management and Industrial Geophysics at Schlumberger, 1920-1940, Cambridge, The MIT Press.
  2. Bruni, A. (2003a), La socialità degli oggetti e la materialità dell’organizzare. Etnografia di un progetto di telemedicina. Tesi di Dottorato, Dipartimento di Sociologia e Ricerca Sociale, Università di Trento.
  3. Bruni, A. (2003b), Lo studio etnografico delle organizzazioni, Roma, Carocci.
  4. Bruni, A. (2013a), “Technologically Dense Environments: The Genesis of a Scientific Fact?”, TECNOSCIENZA Italian Journal of Science & Technology Studies 4, 2: 51-72.
  5. Bruni, A. (2013b), “La sicurezza come pratica di lavoro: oggetti tecnici, visioni professionali e processi comunicativi”, Sociologia del lavoro, 130: 52-68,, DOI: 10.3280/SL2013-130004
  6. Czarniawska, B. (2007), Shadowing and Other Techniques for Doing Fieldwork in Modern Societies, Malmö, Copenhagen Business School Press.
  7. Cohen, I.J. (1996), “Theories of Action and Praxis”, in B.S. Turner (ed.), The Blackwell Companion to Social Theory, Cambridge, Blackwell.
  8. Darkins, A.W., Cary, M.A. (2000), Telemedicine and Telehealth: Principles, Policies, Performances and Pitfalls, New York, Springer Publishing Company.
  9. Dourish, P., Adler, A., Bellotti, V., Henderson, A. (1996), “Your Place or Mine? Learning from Long-Term Use of Audio-Video Communication”, Computer Supported Cooperative Work, 5, 1: 33–62,, DOI: 10.1007/BF00141935
  10. Dykstra, R. H., Ash, J. S., Campbell, E., Sittig, D. F., Guappone, K., Carpenter, J., McMullen, C. (2009), “Persistent Paper: The Myth of “Going Paperless””, AMIA Annual Symposium Proceedings, 2009: 158-162.
  11. Fitzpatrick, G., Ellingsen, G. (2013), “A Review of 25 Years of CSCW Research in Healthcare: Contributions, Challenges and Future Agendas”, Computer Supported Cooperative Work, 22, 4-6: 609-665,, DOI: 10.1007/S10606-012-9168-0
  12. Fletcher, J. K. (1999), Disappearing Acts: Gender, Power, and Relational Practice at Work, MIT Press.
  13. Gherardi, S. (2006), Organizational Knowledge: The Texture of Workplace Learning.
  14. Malden, Wiley-Blackwell, MA. Gherardi, S. (2010), “Telemedicine: A Practice-based Approach to Technology”, Human Relations, 63, 4: 501-524,, DOI: 10.1177/0018726709339096
  15. Haraway, D.J. (2013), Simians, Cyborgs, and Women: The Reinvention of Nature. London, Routledge.
  16. Heath, C., Button, G. (2002), “Editorial Introduction”, British Journal of Sociology, 53, 2: 157-161,, DOI: 10.1080/00071310220133278
  17. Heath, C., Luff, P. (2000), Technology in Action, Cambridge, Cambridge University Press.
  18. Heath, C., Luff, P., Svensson, M.S. (2003), “Technology and Medical Practice”, Sociology of Health & Illness, 25, 3: 75-96,, DOI: 10.1111/1467-9566.00341
  19. Hyysalo, S. (2010), Health Technology Development and Use, New York, Routledge.
  20. Knorr Cetina, K. (1997), “Sociality with Objects: Social Relations in Post-Social Knowledge Societies”, Theory, Culture and Society 14, 4: 1-30.
  21. Latour, B. (1987), Science in Action: How to Follow Scientists and Engineers Through Society, Cambridge, Harvard University Press.
  22. Latour, B. (2007), Reassembling the Social: An Introduction to Actor-Network Theory, Oxford, Oxford University Press.
  23. Luff, P., Hindmarsh, J., Heath, C. (2000), Workplace Studies: Recovering Work Practice and Informing System Design, Cambridge, Cambridge University Press.
  24. Nicolini, D. (2006), “The Work to Make Telemedicine Work: A Social and Articulative View”, Social Science & Medicine, 62, 11: 2754-2767,, DOI: 10.1016/J.SOCSCIMED.2005.11.001
  25. Østerlund, C.S. (2008), “Documents in Place: Demarcating Places for Collaboration in Healthcare Settings”, Computer Supported Cooperative Work, 17: 195-225,, DOI: 10.1007/S10606-007-9064-1
  26. Østerlund, C., Carlile, P. (2005), “Relations in Practice: Sorting Through Practice Theories on Knowledge Sharing in Complex Organizations”, The Information Society, 21, 2: 91-107,, DOI: 10.1080/01972240590925294
  27. Parolin, L.L. (2008), “Workplace Studies: tecnologia ed interazione sociale nei contesti di lavoro”, Studi organizzativi, 1: 145-165.
  28. Piras, E.M. (2011), “This is not something I should be doing”. Junction work and professional identity of nurses grappling with health information systems, Proceedings of the 5th Human Factors Engineering in Health Informatics Symposium, Trondheim, Norway.
  29. Piras, E.M., Zanutto, A., Eccher, C. (2011), When work becomes opaque. Nurses at the junctions of medical Infrastructures, Proceedings of the 3rd International Workshop on Infrastructures for Healthcare, University of Copenhagen. Sellen, A.J., Harper, R. HR. (2002), The Myth of the Paperless Office, Cambridge, MIT Press.
  30. Star, S.L. (1999), “The Ethnography of the Infrastructure”, American Behavioral Science 43: 377-91,, DOI: 10.1177/00027649921955326
  31. Star, S.L., Strauss, A. (1999), “Layers of Silence, Arenas of Voice: The Ecology of Visible and Invisible Work”, Computer Supported Cooperative Work, 8: 9-30,, DOI: 10.1023/A:100865110535
  32. Star, S.L., Ruhleder, K. (1996), “Steps toward an Ecology of Infrastructure: Design and Access for Large Information Spaces”, Information Systems Research, 7, 1: 111-134,, DOI: 10.1287/isre.7.1.111
  33. Suchman, L., Blomberg, J., Orr, J.E. (1999), “Reconstructing Technologies as Social Practice”, The American Behavioral Scientist, 43, 3: 392-408,, DOI: 10.1177/00027649921955335
  34. Timmermans, S., Berg, M. (2004), The Gold Standard: The Challenge of Evidencebased Medicine and Standardization in Health Care, Philadelphia, PA, Temple University Press.
  35. Whalen, J., Whalen, M., Henderson, K. (2002), “Improvisational Choreography in Teleservice Work”, British Journal of Sociology, 53, 2: 239-258,, DOI: 10.1080/0007131022013332

Enrico Maria Piras, Alberto Zanutto, in "STUDI ORGANIZZATIVI " 1/2014, pp. 29-49, DOI:10.3280/SO2014-001002


FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content